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Pennsylvania rates for HCPCS 90964

Esrd Svc Home Dialysis Full Month 2-11 Yr Old

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$493.94 / $493.94 / $493.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.39 / $493.94 / $610.48
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.36 / $535.84 / $862.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.85 / $591.85 / $591.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.24 / $582.21 / $1,006.07
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,125.39 / $1,125.39 / $1,125.39
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.15 / $705.15 / $1,055.29
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$441.95 / $509.70 / $945.11
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$564.15 / $926.89 / $1,303.09
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.85 / $591.85 / $591.85
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.24 / $583.91 / $1,005.29
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.31 / $508.31 / $508.31
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.29 / $508.60 / $528.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.12 / $511.49 / $889.10